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Mental health is largely shaped by the daily environments in which people live their lives, with positive components of mental health emphasising the importance of feeling good and functioning effectively. Promoting mental health relies on broad-based actions over multiple sectors, which can be difficult to measure. Different types of Impact Assessment (IA) frameworks allow for a structured approach to evaluating policy actions on different levels. A systematic review was performed exploring existing IA frameworks relating to mental health and mental wellbeing and how they have been used. A total of 145 records were identified from the databases, from which 9 articles were included in the review, with a further 6 studies included via reference list and citation chaining. Five different mental-health-related IA frameworks were found to be implemented in a variety of settings, mostly in relation to evaluating community actions. A Narrative Synthesis summarised key themes from the 15 included articles. Findings highlight the need for participatory approaches in IA, which have the dual purpose of informing the IA evaluation and advocating for the need to include mental health in policy development. However, it is important to ensure that IA frameworks are user-friendly, designed to be used by laypeople in a variety of sectors and that IA frameworks are operational in terms of time and monetary resources.

Purpose The purpose of this paper is to investigate positive mental health (PMH) and factors related to it among those living alone in the sparsely populated area of the Lapland region. Design/methodology/approach The study utilises data from the Mental Health Survey of the Lapland region in Finland, covering 12 municipalities. The scores of short Warwick–Edinburgh Mental Well-Being Scale (sWEMWBS) were categorised into three levels of PMH. Logistic regression models were used to separately estimate the odds ratios for the high level of PMH compared with the moderate level of PMH and the low level of PMH compared with the moderate level. Findings Social support seemed to be very strongly associated with both low and high levels of PMH among people living alone. Participating in activities provided by organisations or societies decreased the odds of having low PMH. Among men, young age predicted low PMH. Originality/value The number of people living alone in Finland and other parts of Europe is increasing, yet there are few studies focusing on their positive mental health (PMH). Using scales such as sWEMWBS adds to the authors’ knowledge about the positive mental well-being of those living alone, especially in rural areas, thus making it possible to utilise mental health promotion interventions effectively and accordingly.

Objective: The aim is to report the outcomes of the suicide prevention training in terms of the self-perceived impact on the participants. Design: The three-hour training consisted areas of risk and protective factors, screening and evaluating suicide risk, raising concerns and confronting suicidal patients, and treating suicidal ideation in primary healthcare and the associated referral processes. Subjects: The studied participants consisted of general practitioners, nurses, public health nurses and social work professionals. Main outcome measures: Participants assessed their own competence on online form regarding four training areas prior to and two weeks after the training. Results: The response rate was 25%. The self-perceived competence of the healthcare professionals increased in all training areas and in all occupational groups. The healthcare professionals’ competence regarding the risk and protective factors training area saw the greatest increase across all professional groups except nurses. There were, however, differences between the groups. Conclusion: Suicide prevention training for primary healthcare professionals did increase the self-perceived competence of the participants in all areas covered by the training. Regular follow-up training is required in order for these improvements to be further developed and retained.Key pointsAfter the suicide prevention training all participants self-perceived increase in their competence in all training areas.The GPs self-perceived most increase in risk and protective factors and nurses in raising concerns and confronting suicidal patients.The GPs’ lowest increase was in the area of treating suicidal ideation in primary health care and the referral processes.

Background Living alone has increased globally and especially in Finland where 45% of all households are single occupancy. Epidemiological research has found that living alone a risk factor for a wide range of adversities related to quality of life but the rapidly-changing demographics of people living alone calls for a more detailed investigation of their subjective health status. Methods Using a cross-sectional survey sent for a random sample of Finnish residents in single-person households (n = 884), we explored with latent class analysis whether the respondents form different health profiles based on the three health dimensions defined by the World Health Organization: physical, social, and mental well-being. The identified groups were then compared in terms of demographic characteristics with the χ2 test and quality of life using linear regression models. Sensitivity analyses were run using more refined, manual 3-step BCH method. Results Four distinct health profiles were found: Languishing (4%), Managing (35%), Healthy (30%), and Flourishing (31%). The groups differed in most socio-demographic aspects such as marital and employment status, but not in terms of geographic location or gender (apart from group Languishing that contained more men). Controlling for these socio-demographic differences, all groups showed different average levels of perceived quality of life to the expected direction. Conclusions Our findings suggest that people living alone are indeed a very heterogeneous group in terms of subjective health. Instead of seeing living alone as a mere risk for low quality of life, concept of living alone should be understood more broadly both in public discussion and scientific research.

Living alone has become more common across Europe. Past research has consistently identified living alone as a risk factor for poor mental health while evidence on the positive dimension(s) of mental health has been scarce. Positive mental health has been associated with rather stable circumstantial factors, such as socio-economic characteristics and social relationships, and day-to-day activities in the form of leisure participation, in general populations. In this study, our objective was to assess these relationships among people living alone. We specified a structural equation model in a random sample of Finnish people living alone (n = 884), with the circumstantial factors as (exogenous) explanatory variables, participation in various leisure activities as mediators, and positive mental health as the outcome. In the model, more frequent engagement in several leisure-time activities, including being in contact with family/friends and physical activity in nature, were positively associated with positive mental health. The circumstantial factors that most strongly explained both leisure participation and positive mental health were the number of friends, being in a relationship, and having no limiting illnesses. In conclusion, among Finnish people living alone, social and functional factors appear to be more strongly associated with leisure participation and positive mental health than socio-economic factors.

Background Positive mental health (PMH) is an important construct for understanding the full continuum of mental health. The aim of this study was to examine the association of family background with the level of PMH among adolescents and young adults in Finland. Methods Data from population-based Finnish School Health Promotion Study targeted at year 8. and 9. students of comprehensive school and year 1. and 2. students of upper secondary school and vocational schools was used (n = 134684) for the study. PMH was measured with short Warwick-Edinburgh-Mental-Wellbeing-Scale (SWEMWBS) and examined on a continuum from languishing (low level of positive mental health) to moderate to flourishing mental health (high level of positive mental health). Associations between flourishing/languishing mental health and family background variables were analysed with logistic regression analysis, school level and gender were adjusted. Results Flourishing mental health was associated with intact family background, higher education of parents and better financial situation of family. In contrast, languishing was associated with non-intact family conditions (single parent family, parents divorced, stepfamily) and parents’ unemployment, lower level of education and financial problems. Conclusions Family structure and socioeconomic status of parents have an impact on PMH of young people. Young people with non-intact family structure and/or poorer socioeconomic status may lack positive sense of well-being, in other words they have challenges to enjoy their life, to believe in their own abilities, to cope with normal stresses of life, to study productively and to enjoy interacting with others. Targeted interventions and promotive actions should be directed for young people with challenging family conditions in particular. Key messages Investigating positive mental health (PMH) is essential for understanding the full continuum of mental health. Family structure and parents’ socioeconomic status have an impact on PMH of young people.

Background Living alone has become more common in today’s societies. Despite the high number of the population living alone, research directed towards the mental wellbeing issues related to living alone has been limited. This systematic literature review aimed to assess the association between living alone and positive mental health. Methods We conducted searches in Medline, Web of Science, Cochrane Library, CINAHL, PsycINFO, and other complementary databases from January 1998 to May 2019. Randomised trials and observational studies investigating adults over 18 years of age and living alone (defined as living in a single household or a household size of one person) were eligible. The primary outcome was positive mental health, defined as comprising both hedonic and eudaimonic elements of mental wellbeing, and it was measured with the Warwick-Edinburgh Mental Well-being Scale and/or theWHO-5 Index. Two reviewers independently screened and selected data; one reviewer extracted data, and the second checked the extracted data. A narrative synthesis described the quality and content of the evidence. Included studies were appraised using relevant Joanna Briggs Institute checklist. Results A total of 4 cross-sectional studies (22,591 adult participants) were included after screening of 341 titles and abstracts and 46 full-text articles. These studies were conducted in Europe and were published between 2014 and 2017. The studies differed in their measurements of positive mental health (WHO-5 Well-Being Index, 3 studies; WEMWBS, 1 study), sources of data (1 regional, 1 national, and 2 European-level studies), and study populations (regional study, adults over 65 years of age; national-level study, mental health nurses over 21 years of age; European-level studies, employees between 15 and 65 years of age and adults over 18 years of age). A potential association between living alone and low positive mental health was found in three out of the four studies. Our findings were limited as the number of included studies was low and the quality of evidence varied across studies. Conclusions This review allows a limited look at the association between living alone and positive mental health. Because the number of included studies was low and the quality of evidence varied across studies, further research is warranted. Electronic supplementary material The online version of this article (10.1186/s13643-019-1057-x) contains supplementary material, which is available to authorized users.

Aims: In this study, we aimed to investigate what competencies are needed for mental health promotion in health sector practice in Finland. Methods: A qualitative study was carried out to seek the views of mental health professionals regarding mental health promotion-related competencies. The data were collected via two focus groups and a questionnaire survey of professionals working in the health sector in Finland. The focus groups consisted of a total of 13 professionals. Further, 20 questionnaires were received from the questionnaire survey. The data were analysed using the qualitative data analysis software ATLAS.ti Scientific Software Development GmbH, Berlin. A content analysis was carried out. Results: In total, 23 competencies were identified and clustered under the categories of theoretical knowledge, practical skills, and personal attitudes and values. In order to promote mental health, it is necessary to have a knowledge of the principles and concepts of mental health promotion, including methods and tools for effective practices. Furthermore, a variety of skills-based competencies such as communication and collaboration skills were described. Personal attitudes and values included a holistic approach and respect for human rights, among others. Conclusions: The study provides new information on what competencies are needed to plan, implement and evaluate mental health promotion in health sector practice, with the aim of contributing to a more effective workforce. The competencies provide aid in planning training programmes and qualifications, as well as job descriptions and roles in health sector workplaces related to mental health promotion.

This study explored and clarified the nature and characteristics of the concept of mental health promotion. The study also investigated how these characteristics appear in current policies and strategies. A total of 30 scientific articles and policy documents were identified and analysed using Rodgers’s systematic evolutionary concept analysis method. The analysis provided valuable information on the attributes, related concepts, antecedents, consequences and references of mental health promotion, indicating that the concept is a distinct concept comprising a unique set of attributes and characteristics. A concept mapping of mental health promotion was subsequently developed. The analysis and the concept mapping provide health professionals, policy-makers and researchers with a framework, upon which well-grounded mental health promotion practice and evaluation research can be based.

Introduction The relationship between physical activity (PA) and positive mental health (PMH) has been studied mainly by either concentrating on total PA or focusing on leisure time PA. This study investigated whether total PA and PA domains of leisure time, commuting and occupational PA and screen time sitting at home were associated with PMH. Methods The study used a national population study, the FinHealth 2017 Study that included the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) as a measurement for PMH. Of all (n = 10305, of whom 10247 were eligible) invited, 58.1% (5952) participated in health examination and were given a questionnaire including the WEMWBS. A total of 5337 (52.1% of the eligible sample, 89.7% of the health examination participants) returned the questionnaire. The WEMWBS scale was adequately completed by 5090 participants (55.6% women, mean age 55.5 years). Low, moderate and high level of PMH categories were formed. Leisure time, occupational and commuting PA domains were assessed separately and together as a total PA index. Also, screen time sitting at home was measured. Binary logistic regression models were utilized to estimate the odds ratios for having low PMH compared with moderate PMH and separately for having high PMH compared with moderate PMH. The models were estimated both with and without adjustment for potential confounders. Results Physical inactivity (total PA) was associated with lower levels of PMH. Some of the PA domains were strongly associated with low PMH; leisure time physical inactivity and long screen time sitting at home were strongly related to higher odds of low PMH. Commuting PA was associated with high PMH. Conclusions The study highlights the importance of PA with relation to PMH among adults. Especially, physical inactivity was strongly associated with low PMH. As low levels of PMH can potentially present a risk for mental ill-health, this study suggests it is important to increase PA among the least active population.

Purpose Effective public mental health policy and practice call for a trained workforce that is competent in mental health promotion and delivering on improved mental health. Systematic information on what competencies are needed for mental health promotion practice in the health sector is lacking. The purpose of this paper is to investigate these competencies for mental health promotion. Design/methodology/approach A Delphi survey was carried out to facilitate a consensus-building process on development of the competencies. Professionals (n=32) working in mental health and mental health promotion took part in the survey. The experts were asked their professional views on the needed competencies as well as to rank the importance of the competencies. Two questionnaire rounds were carried out in order to reach consensus. Findings In total, 16 main competencies and 56 subcompetencies were identified through the Delphi survey. The competencies were divided into three category domains: theoretical knowledge, practical skills and attitudes and values each category representing an important aspect of mental health promotion competency. Practical implications The competencies provide a resource for workforce development, as they illustrate what theoretical knowledge, practical skills and attitudes and values are required. They provide an instrument to enhance education and training programmes in mental health promotion contributing to a more skilled workforce and improved quality of practice as well. Originality/value A strong consensus was reached within the participating experts, them viewing all competencies as important. The identified competencies highlight the great variety of different competencies and competency areas that are needed for effective mental health promotion practice in the health sector.

Suicide as a stigmatising issue presents a huge challenge for prevention policy. Also, policy itself is often difficult to turn into action. This research describes the interpretative repertoires found in the suicide prevention strategies of England and Finland, and explores their potential functions and audiences. It was found that the political repertoire was formed from four sub‐repertoires: the public health epidemiology, the everyday, the preventive action and the reflective repertoires. This paper discusses the polyphonic and multilayered nature of these policy documents and how different repertoires may be used for various functions. The polyphonic nature of policy documents is necessary to reach a wide readership and to capture suicide as a controversial phenomenon. However, the downside is that the argumentative style may also undermine some of the measures and actions recommended.

Background: In order to develop policymaking, evaluation is required. The research project studied national health promotion policies concentrating on mental health promotion policy. In this paper the focus is on the position of evaluation. Aim: To explore the position of evaluation in the development of the national public health strategies of England and Finland and particularly with regard to mental health promotion policies. The evaluation phase of the policymaking process is also scrutinised through multiple streams of policy change. Methods: Meta-evaluative approach applying a conceptual framework of policy analysis. Results: Evaluations of national health strategies were executed in both countries. These evaluations entailed multiple tasks; not only to monitor the progress of the targets but to learn for the future in a wider perspective. Aims of mental health policy are not easily turned into quantitative targets and therefore outcome evaluation was not felt to be satisfactory as it lacks focus on process as well as null, perverse, and unintended consequences. Conclusions: While the position of evaluation is almost always more complicated than is assumed in so-called rational policymaking theory, mental health appears to be even more challenging in this respect. Possibilities for alternative evaluation strategies should be studied further.

This paper reports on an exploratory analysis of the determinants of mental health in health policy documents from Finland, Sweden, Denmark, The Netherlands, England and Portugal during 1985—2004. Similarities and differences in mental and somatic health were examined, using qualitative content analysis. The results of the analysis are compared with some frequently applied health determinant conceptualisations and with the conclusions of previous research. The paper concludes by pointing out that the determinants of mental and somatic health are constructed differently, which seems to affect the design of health promotion policy.

The aim of this study is to analyse the position and role of mental health in health promotion policy. Policy documents from Finland, Sweden, Denmark, the Netherlands, England and Portugal indicate that, although mental health is considered a serious issue, it is problematic in policy terms. A range of arguments are put forward, making the case for the importance of mental health within the health promotion agenda, including the classification of mental illness as a public health problem, socio‐economic and individual costs of mental health problems and the view that mental well‐being is a crucial element of overall health. However problems of definition, measurement and a traditional focus on treatment and care continue to make mental health promotion problematic for policy makers.